What payers pay, by CPT code

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Office visits & evaluation (E/M) (26)

• CPT 99214 · Office visit, established patient, 30-39 min median $127.96
• CPT 99213 · Office visit, established patient, 20-29 min median $92.75
• CPT 99204 · Office visit, new patient, 45-59 min median $180.91
• CPT 99212 · Office visit, established patient, 10-19 min median $52.81
• CPT 99203 · Office visit, new patient, 30-44 min median $116.74
• CPT 99211 · Office visit, established patient, minimal median $22.24
• CPT 99215 · Office visit, established patient, 40-54 min median $185.97
• CPT 99396 · Preventive visit, established pt, age 40-64 median $137.31
• CPT 99385 · Preventive visit, new pt, age 18-39 median $144.94
• CPT 99283 · Emergency dept visit, level 3 median $91.78
• CPT 99291 · Critical care, first 30-74 min median $320.69
• CPT 99284 · Emergency dept visit, level 4 median $159.79
• CPT 99285 · Emergency dept visit, level 5 median $235.60
• CPT 99395 · Preventive visit, established pt, age 18-39 median $127.25
• CPT 99282 · Emergency dept visit, level 2 median $54.88
• CPT 99292 · Critical care, each additional 30 min median $146.72
• CPT 99394 · Preventive visit, established pt, age 12-17 median $126.26
• CPT 99384 · Preventive visit, new pt, age 12-17 median $153.05
• CPT 99383 · Preventive visit, new pt, age 5-11 median $132.53
• CPT 99392 · Preventive visit, established pt, age 1-4 median $110.92
• CPT 99391 · Preventive visit, established pt, infant median $108.99
• CPT 99397 · Preventive visit, established pt, 65+ median $148.83
• CPT 99281 · Emergency dept visit, level 1 median $20.47
• CPT 99393 · Preventive visit, established pt, age 5-11 median $111.52
• CPT 99381 · Preventive visit, new pt, infant median $123.89
• CPT 99382 · Preventive visit, new pt, age 1-4 median $131.66

Imaging & radiology (7)

• CPT 73610 · X-ray, ankle, 3+ views median $37.44
• CPT 72110 · X-ray, lumbar spine, 4+ views median $53.59
• CPT 73562 · X-ray, knee, 3 views median $42.68
• CPT 72100 · X-ray, lumbar spine, 2-3 views median $40.22
• CPT 73501 median $32.34
• CPT 73721 · MRI, lower extremity joint, w/o contrast median $234.26
• CPT 76872 median $170.82

Surgery & procedures (70)

• CPT 27447 median $1,773.60
• CPT 23472 median $1,984.75
• CPT 29827 · Shoulder arthroscopy, rotator cuff repair median $1,474.28
• CPT 28296 median $816.57
• CPT 45378 · Diagnostic colonoscopy median $321.28
• CPT 20610 · Major joint injection (shoulder, hip, knee) median $78.50
• CPT 20605 · Aspiration/injection, intermediate joint median $66.35
• CPT 17110 · Destruction, benign lesions, up to 14 median $108.84
• CPT 20550 · Tendon sheath/ligament injection median $66.90
• CPT 10060 · Incision and drainage of abscess, simple median $145.92
• CPT 27502 median $1,110.95
• CPT 20600 · Aspiration/injection, small joint (e.g., finger) median $63.67
• CPT 10061 · Incision and drainage of abscess, complex median $253.78
• CPT 17000 · Destruction, premalignant lesions, first median $75.86
• CPT 64612 median $190.11
• CPT 11900 median $52.51
• CPT 45380 · Colonoscopy w/ biopsy median $378.41
• CPT 20551 · Tendon origin/insertion injection median $61.68
• CPT 29881 · Knee arthroscopy w/ meniscectomy median $818.74
• CPT 28285 median $620
• CPT 12001 · Simple wound repair, ≤2.5cm median $89.16
• CPT 43239 · EGD w/ biopsy median $318.55
• CPT 17111 · Destruction, benign lesions, 15+ median $124.60
• CPT 45385 · Colonoscopy w/ polyp removal (snare) median $470.47
• CPT 11730 · Avulsion of nail plate, single median $93.39
• CPT 64483 · Lumbar epidural injection, single level median $218.88
• CPT 12011 · Simple repair, face/lip/eyelid, ≤2.5cm median $108.68
• CPT 11055 · Paring of corn or callus, single median $31.99
• CPT 11720 · Debridement of nails, 1-5 median $28.29
• CPT 11721 · Debridement of nails, 6+ median $46.21
• CPT 17003 · Destruction, lesions 2-14, each median $4.66
• CPT 36415 · Routine venipuncture median $6.72
• CPT 64484 · Lumbar epidural injection, each additional median $98.15
• CPT 11300 · Shaving lesion, trunk/arms/legs, ≤0.5cm median $64.29
• CPT 43235 · EGD, diagnostic median $270.03
• CPT 11901 median $69.84
• CPT 11301 · Shaving lesion, trunk/arms/legs, 0.6-1cm median $92.36
• CPT 27500 · Closed treatment of femoral shaft fracture median $716.55
• CPT 11732 · Avulsion of nail plate, each additional median $35.41
• CPT 11056 median $44.98
• CPT 11306 · Shaving lesion, scalp/neck/hands/feet, 0.6-1cm median $93.30
• CPT 11305 · Shaving lesion, scalp/neck/hands/feet, ≤0.5cm median $73.29
• CPT 20611 · Major joint injection w/ ultrasound guidance median $113
• CPT 45384 · Colonoscopy w/ tumor removal, hot biopsy median $413.74
• CPT 11057 median $56.13
• CPT 52000 · Cystoscopy median $181.85
• CPT 64635 · Lumbar facet RFA, single level median $405.74
• CPT 51700 median $67.20
• CPT 45379 median $420.72
• CPT 28470 · Closed treatment of metatarsal fracture median $291.57
• CPT 52310 · Cystoscopy w/ stent removal median $303.97
• CPT 55706 median $514.58
• CPT 64493 · Facet joint injection, lumbar, single level median $179.41
• CPT 51701 median $47.53
• CPT 64633 · Cervical/thoracic facet RFA, single level median $404.71
• CPT 43245 · EGD w/ dilation gastric outlet median $392.66
• CPT 45386 · Colonoscopy w/ balloon dilation median $382.94
• CPT 52315 median $486.34
• CPT 53600 median $100.47
• CPT 64636 · Lumbar facet RFA, each additional median $120.41
• CPT 64494 · Facet joint injection, lumbar, second level median $98.59
• CPT 53601 median $84.77
• CPT 64491 · Facet joint injection, cervical/thoracic, second median $114.69
• CPT 64490 · Facet joint injection, cervical/thoracic, single median $207.33
• CPT 64495 · Facet joint injection, lumbar, third+ level median $99
• CPT 64634 · Cervical/thoracic facet RFA, each additional median $132.98
• CPT 43257 median $339.25
• CPT 62323 · Lumbar epidural injection w/ imaging guidance median $197.28
• CPT 62321 · Cervical/thoracic epidural injection median $208.15
• CPT 55700 · Prostate biopsy, needle median $330.41

Lab & pathology (4)

• CPT 82947 · Glucose, quantitative median $3.54
• CPT 80053 · Comprehensive metabolic panel median $9.50
• CPT 85025 · CBC w/ differential, automated median $6.99
• CPT 80061 · Lipid panel median $11.85

Medicine & procedures (73)

• CPT 92250 · Fundus photography median $39.68
• CPT 95886 · Complete needle EMG median $89.19
• CPT 92083 · Visual field exam, extended median $62.10
• CPT 92081 · Visual field exam, limited median $33.28
• CPT 93306 · Transthoracic echocardiogram, complete median $202.16
• CPT 93971 · Extremity venous duplex, limited or unilateral median $124.24
• CPT 93308 median $102.10
• CPT 93970 · Extremity venous duplex, complete bilateral median $190.40
• CPT 93880 · Carotid duplex ultrasound, complete median $197.34
• CPT 95816 · EEG, awake & drowsy median $354.38
• CPT 91010 median $213.88
• CPT 95909 · Nerve conduction studies, 5-6 studies median $124.39
• CPT 95819 · EEG, awake & asleep median $417.03
• CPT 95908 · Nerve conduction studies, 3-4 studies median $105.08
• CPT 93307 · Transthoracic echo, w/o spectral Doppler median $136.89
• CPT 95907 · Nerve conduction studies, 1-2 studies median $82.54
• CPT 95810 median $599.33
• CPT 93350 · Stress echocardiogram median $180.28
• CPT 93882 median $130.81
• CPT 95811 median $627.23
• CPT 97110 · Therapeutic exercise, 15 minutes median $31.35
• CPT 97150 · Group therapeutic procedures median $18.93
• CPT 97163 · PT evaluation, high complexity median $101.44
• CPT 92100 median $72.22
• CPT 97164 · PT re-evaluation median $71.40
• CPT 97763 median $58.66
• CPT 97112 · Neuromuscular reeducation, 15 minutes median $34.85
• CPT 97140 · Manual therapy techniques, 15 minutes median $29.26
• CPT 97750 · Physical performance test median $36.06
• CPT 97165 · OT evaluation, low complexity median $102.45
• CPT 97166 · OT evaluation, moderate complexity median $102.45
• CPT 97530 · Therapeutic activities, 15 min median $37.95
• CPT 97167 · OT evaluation, high complexity median $102.45
• CPT 97168 · OT re-evaluation median $70.77
• CPT 97035 · Ultrasound therapy, 15 minutes median $15.14
• CPT 97124 · Massage therapy, 15 min median $28.18
• CPT 97116 · Gait training therapy median $31.87
• CPT 97014 · Electrical stimulation, unattended median $14.80
• CPT 93000 · Electrocardiogram, complete median $22.90
• CPT 97026 · Infrared therapy median $7.16
• CPT 93798 median $26
• CPT 90837 · Psychotherapy, 60 minutes median $171.77
• CPT 90792 · Psychiatric diagnostic eval w/ medical median $223.62
• CPT 97761 median $42.44
• CPT 93010 · ECG, interpretation only median $11.68
• CPT 93040 median $18.36
• CPT 97162 · PT evaluation, moderate complexity median $101.44
• CPT 90834 · Psychotherapy, 45 minutes median $120.47
• CPT 90791 · Psychiatric diagnostic evaluation median $195.01
• CPT 97012 · Mechanical traction median $16.65
• CPT 97760 · Orthotic management & training median $50.89
• CPT 97535 · Self-care management training, 15 min median $34.32
• CPT 97161 · PT evaluation, low complexity median $101.44
• CPT 90847 · Family psychotherapy with patient, 50 min median $131.10
• CPT 90832 · Psychotherapy, 30 minutes median $90.24
• CPT 98943 · Chiropractic manipulative treatment, extraspinal median $26.21
• CPT 93042 median $9.95
• CPT 92014 · Eye exam, established patient, comprehensive median $108
• CPT 98941 · Chiropractic manipulative treatment, 3-4 spinal regions median $38.73
• CPT 92004 · Eye exam, new patient, comprehensive median $124.39
• CPT 96136 · Test administration, first 30 min median $44.68
• CPT 92012 · Eye exam, established patient, intermediate median $71.17
• CPT 98942 · Chiropractic manipulative treatment, 5 spinal regions median $50.11
• CPT 90853 · Group psychotherapy median $36.54
• CPT 90846 · Family psychotherapy w/o patient, 50 min median $128.54
• CPT 98940 · Chiropractic manipulative treatment, 1-2 spinal regions median $27.21
• CPT 96116 median $115.50
• CPT 92002 · Eye exam, new patient, intermediate median $78
• CPT 96138 · Test administration by technician, first 30 min median $47.07
• CPT 90460 · Vaccine admin, first/only component, age <19 median $27.85
• CPT 90839 · Crisis psychotherapy, first 60 min median $173.62
• CPT 90840 · Crisis psychotherapy, each additional 30 min median $85.40
• CPT 90461 · Vaccine admin, each additional component median $13

Other codes (15)

• CPT E0135 median $34.50
• CPT E0601 median $247.70
• CPT E0114 median $32.84
• CPT E0116 median $19.76
• CPT E0130 median $34.41
• CPT K0002 median $292.67
• CPT K0001 median $166.50
• CPT K0003 median $249.17
• CPT L1906 median $112.46
• CPT L3020 median $193.66
• CPT A4253 median $7.49
• CPT A4259 median $1.21
• CPT A4570 median $13.77
• CPT A9900 median $50
• CPT E1399 median $50